General Terms & Conditions of Insurance Safe Travels

Transcription

1 Good to know there s SIGNAL IDUNA. General Terms & Conditions of Insurance Safe Travels

2 Table of contents I. COMMON PROVISIONS p General provisions p Definitions p Conclusion of insurance contract p Insurance period/liability period p Withdrawal and termination of insurance contract p Sum insured p Insurance premium p Procedure in the event of damage. General provisions p Determination and payment of benefit/compensation under medical expenses, personal accident, third party liability, travel luggage and sports equipment insurance p Deadline for payment of benefit p Procedure of examining appeals, complaints and requests p Recourse claims p. 19 II. MEDICAL EXPENSES AND ASSISTANCE INSURANCE p Subject of insurance p Limitations of liability p Procedure in the event of sudden illness or personal accident p. 28 III. PERSONAL ACCIDENT INSURANCE p Subject of insurance p Limitations of liability p Procedure in the event of sudden illness or personal accident p. 32 IV. TRAVEL LUGGAGE INSURANCE p Subject of insurance p Limitations of liability p Procedure in the event of damage to luggage p. 34 V. SPORTS EQUIPMENT INSURANCE p Subject of insurance p Limitations of liability p Procedure in the event of damage to sports equipment p. 36 VI. LEGAL PROTECTION AND AID INSURANCE p Subject of insurance p Limitations of liability p. 38 VII. GENERAL THIRD PARTY LIABILITY INSURANCE p Subject of insurance p Limitations of liability p Procedure in the event of damage under third party liability p. 40 VIII. FINAL PROVISIONS p. 40 2

3 General Terms&Conditions of Insurance. Safe Travels I. COMMON PROVISIONS 1. GENERAL PROVISIONS 1. On the grounds of the present General Terms and Conditions of Insurance, hereinafter referred to as the GT&C, SIGNAL IDUNA Polska Towarzystwo Ubezpieczeń Spółka Akcyjna, hereinafter referred to as SIGNAL IDUNA, concludes insurance contracts with: a) natural persons having their place of residence either in the territory of the Republic of Poland or outside it, during their trip abroad (TRAVEL variant and personal version of BUSINESS variant); b) entrepreneurs (in the understanding of Article 4.1 of the Act on Freedom of Economic Activity of 2 July 2004 (Journal of Laws of 2007, No. 155, item 1095, as amended) having their place of registered office in the territory of the Republic of Poland. An entrepreneur can conclude an insurance contract for the benefit of persons employed or appointed by such an entity (BUSINESS variant). 2. On the grounds of the present GT&C, SIGNAL IDUNA concludes insurance contracts in the following scope: a) medical expenses (incl. rescue) and assistance insurance; b) personal accident insurance; c) legal protection and aid insurance; d) travel luggage insurance; e) third party liability insurance; f) sports equipment. The selected insurance contract must include medical expenses and assistance insurance, personal accident insurance and legal protection and aid insurance. In addition, the Policyholder may take out any auxiliary insurance cover selected from points d)-f), save that it is possible to take out sports equipment insurance only if travel luggage insurance has been taken out. 3. At the Policyholder s request and upon payment of an additional premium, the scope of the insurance contract may be extended: a) as regards medical expenses (incl. rescue) and assistance insurance, to risks related to: 1) performing physical work abroad (WA code); 2) consequences of chronic diseases and cancer (CP code); 3) practising winter sports (SZ code); 4) practising high risk sports (HR code); 5) practising record-seeking sports (SP code); 6) practising extreme sports (SM code); b) as regards personal accident insurance, to risks related to: 1) performing physical work abroad (WA code); 2) practising winter sports (SZ code); 3) practising high risk sports (HR code); 4) practising record-seeking sports (SP code); c) as regards sports equipment insurance and third party liability insurance, to risks related to practising winter sports (SZ code). 3

4 4. Coverage of the extreme sports risk results in the coverage of risks related to practising winter sports, practising high risk sports and practising recordseeking sports without the need to pay an additional premium, and in the case of combining additional sports risks, the highest increase in the premium covers all sports risks covered by the lower increase. 5. Insurance covers amateur practising of sports without the need to extend the insurance contract. 6. The insurance is available in two variants: TRAVEL or BUSINESS. 7. Medical expenses and assistance insurance in TRAVEL variant is available in two options: standard or super; BUSINESS variant includes super option of medical expenses and assistance insurance. 8. BUSINESS variant differs from the TRAVEL variant by: a) extended assistance package; b) duration of the policy (only 6 or 12-months periods); c) possibility to take out bearer s insurance (cover provided throughout the term of the contract, exclusively for the number of man-days for which the premium has been paid). 9. With the Policyholder s approval, additional provisions or ones differing from those specified in these GT&C may be introduced to the insurance contract. 10. Such differing provisions referred to in item 9 must be introduced in writing and their full text must be incorporated in the insurance contract, otherwise being null and void. 11. The content of the insurance contract and its final wording is decided on by the Policyholder, i.e. the Policyholder decides on the subject of insurance, insurance variant and option. 2. DEFINITIONS The terms used in these GT&C mean: 1. Amateur practising of sport - practising sport exclusively to keep fit or regenerate, for recreational purposes or as a form of active leisure. 2. Travel agent - an entrepreneur whose activity consists in acting permanently as an agent in concluding contracts for travel services for the benefit of tour operators holding a valid permit to conduct such an activity in the territory of the Republic of Poland or for other service providers based in the territory of the Republic of Poland. 3. Acts of terrorism - illegal, collective or individual action using violence against persons or objects, aimed at intimidating or disrupting public life (schools, transport, workplaces, etc.). 4. Out-patient clinic - an open health service unit in which medical aid is rendered in the range of diagnostics and therapy by qualified medical and nursing staff. In the understanding hereof this term does not cover alms-houses, hospicium, drug and alcohol abuse cure centres, health resort centres, preventorium and rehabilitation units or centres. 5. Travel luggage - objects customarily taken for a trip, clothes, shoes, cosmetics, perfumes, small appliances (hairdryer, electric curler, iron), medicines prescribed by a doctor, manometers, glucose meters, hearing aids, crutches, walking sticks, corrective glasses, sunglasses, wheelchairs (if required by the Insured s state of health), pushchairs, small gifts and souvenirs as well as mobile phones, photographic and computer equipment, audio-visual equipment, if they are stored as provided for in 19 item 2 and if they form part of hand luggage. 6. Travel agency - an entrepreneur registered in the territory of the Republic of Poland organising trips or acting as an agent in concluding contracts for the provision of travel services, or a travel agent. 4

5 7. Emergency Call Centre - organizational unit appointed by SIGNAL IDUNA which the Policyholder or the Insured is obliged to notify of the occurrence of an event covered by insurance, subject to the provisions of 14 item Genetic disease - a deviation from the normal condition impairing one s capability in daily life, which is transmitted as a hereditary characteristic from one generation to another, or which arises as a result of changes or disorders in mechanisms of transmitting hereditary characteristics. 9. Neoplastic disease (cancer) - a medical condition consisting of an uncontrolled growth of tissue of a particular organ. The condition can be of chronic character or it can appear with severe symptoms occurring suddenly. 10. Chronic disease - any disorder or deviation from the normal condition characterised by one or more of the following: is permanent, entails disability, is caused by irreversible pathologic changes, requires special rehabilitation, requires long-term supervision, observation, treatment or care. It can be treated permanently or periodically. 11. Insurance document - a policy, card, certificate or any other document confirming the conclusion of an insurance contract by the parties. 12. Acting under the influence of alcohol - acting in a condition when blood alcohol content exceeds 0.0 or breath alcohol content exceeds 0.0 mg per 1 dm³. 13. Expedition - an organized trip aimed at the implementation of the assumed sport - or science-oriented tasks. 14. Epidemic - occurrence of cases of infection with or contraction of a contagious disease in a given area, the number of such cases being markedly higher than in the past; or occurrence of cases of infection with or contraction of a contagious disease not occurring before. 15. Integral franchise - a determined amount up to which SIGNAL IDUNA will not be liable for damage Deductible - a determined amount by which the amount of compensation paid out by SIGNAL IDUNA is reduced. 17. Cash - domestic and foreign notes and coins. 18. Waiting period - a waiting time as defined hereunder during which SIGNAL IDUNA bears no liability for any damage, despite the fact that the insurance has been concluded. Liability of SIGNAL IDUNA commences upon the expiry of the waiting period. SIGNAL IDUNA collects the premium exclusively for the period of the cover provided. 19. Natural disaster - an event connected with the action of forces of nature, resulting in drastic changes in the environment, its causes including without limitation atmospheric discharges, seismic shocks, strong winds, heavy atmospheric precipitations, prolonged impact of extreme temperatures, landslides, fires, droughts, floods, ice phenomena on rivers and seas as well as lakes and water bodies, mass pest infestation, plant or animal diseases or human infectious diseases or impact of other natural forces. 20. Assistance and medical expenses costs connected with sudden illness or personal accident as specified in Burglary - a seizure of property upon removal of the existing locks by means of physical force or tools or by means of a forged key or a master-key or by means of the genuine key into possession of which the perpetrator entered in the consequence of breaking into other premises or a robbery. 22. Country of permanent residence - the country in which the Insured is covered by social security on the basis of residence permit or citizenship. 23. Out-patient treatment - treatment not involving an uninterrupted, at least 24-hours long stay in hospital or another medical care unit. 24. Preventive odontotherapy - therapy of caries, therapy of necrotic changes, channel treatment, exchange of damaged fillings, treatment of gingival diseases (paradontosis, dental calculus removal). 5

6 25. Hospitalization - a stay in hospital lasting at least 24 hours. 26. Number of man-days - the product of days and people covered by insurance. 27. Sudden illness - morbid symptoms occurring suddenly which constitute a threat to the Insured s health or life, requiring immediate medical care, which cause the need to undergo treatment before the trip is ended. 28. Consequence of a chronic / neoplastic disease (cancer) - intensification (acuition) of an acute chronic/ neoplastic disease (cancer) occurring in a sudden way after crossing the border of the country of permanent residence and requiring immediate medical aid, resulting in the need to undergo treatment before the trip abroad is over. 29. NBP - the National Bank of Poland. 30. Personal accident - a sudden event caused by external circumstances, in the consequence of which the Insured, irrespective of his/her will, suffered a permanent injury to the body or health disorder, or died. 31. Insurance period - period indicated in the insurance document as requested by the Policyholder during which SIGNAL IDUNA provides insurance. 32. Next-of-kin - spouse, parents, siblings, children, adopted child as well as his/her spouse, civil law spouse, grandparents, parents-in-law, children-inlaw. 33. Accompanying person - the person travelling along with the Insured and indicated by him or her to accompany him or her during the treatment and / or transport recommended by the doctor leading the treatment abroad for the purposes of bringing him or her back to homeland. 34. Pandemic - an epidemic of a contagious illness occurring at the same time in different countries on different continents. 35. Legal protection and aid - assistance connected with third party liability of the Insured or his/her vindicating claims for compensation under third party liability, as described in Physical work - jobs and activities taken up by the Insured while travelling abroad which are either paid for or not, and as part of practical/occupational training, voluntary work and traineeship, which are based mainly on muscle power and practical skills (excluding school and student apprenticeships not having the characteristics of physical work such as apprenticeship at a reception desk, hotel, university/college). Physical work is understood as performing any type of physical work, including without limitation one with the use of dangerous tools, chemical substances, welding work, work on drilling platforms, work with high voltage electrical devices, high altitude work, renovation and construction work, transport (excluding work of drivers going abroad on business trips as ordered by an employer based in the territory of the Republic of Poland - only BUSINESS variant), work in agriculture, work underground, work in iron and steel industry, work in shipyards, work related to tree logging and processing, work in catering sector. Physical work does not mean work performed by the Insured as part of daily-life activities. 37. Premature delivery - delivery occurring not later than in the 32nd week of pregnancy. 38. Robbery - seizure of property using physical constraint or threat of its use towards the Insured or his/her next-of-kin or by driving the Insured unconscious or vulnerable. 39. Insurance premium - the amount which the Policyholder or Insured is obliged to pay to SIGNAL IDUNA for the provision of insurance during the period covered by insurance. 40. Extreme sports - sports disciplines the practising of which requires special skills, braveness and acting under the circumstances of high risk, in particular sports such as parachuting, paragliding, gliding, hot-air ballooning, pilotage of any motor aircraft, mountain cycling, motor sports, canyoning, bungee jumping, canoping, mountaineering, rock climbing, speleology, alpinism, 6

7 ski jumping, skiing outside of designated tracks, bump skiing, acrobatic ski jumping, extreme skiing and snowboarding and sports in which vehicles going on snow or ice are used, as well as participating in expeditions to places characterised by extreme climate or natural conditions (i.e. mountain trekking at altitudes above 3,500 m a.s.l., arctic regions, poles, bush, jungle, glacier or snow areas requiring the use of belaying equipment, desert areas) or in expeditions. 41. High-risk sports - sports such as horseback riding, polo, hunting, paintball, diving with the use of breathing apparatus (scuba diving equipment), ship wreck and cave diving, freediving, sailing, rafting or other water sports practised on mountain rivers, fight sports, any kind of defence arts (if not practised for record-seeking purposes). 42. Winter sports - practising downhill, cross-country skiing or snowboarding on marked ski runs for recreational purposes. 43. Sports equipment - any kind of sports equipment, including accessories for such equipment, used by the Insured while practising sports disciplines for amateur or recreational purposes. 44. Property damage - damage occurring as a damage, destruction or loss of property. 45. Bodily injury - damage occurring as death, injury or health disorder. 46. Hospital - a health service unit providing a day-and-night medical care by a qualified medical and nursing staff in respect of diagnostics and treatment. In the understanding hereof this term does not cover alms-houses, hospicium, drug and alcohol abuse cure centres, health resort centres, preventorium, and rehabilitation units or centres, even where they form an organisational part of a hospital. 47. Permanent health detriment - permanent injury to the Insured s body suffered as a result of a personal accident covered by insurance, whereby the permanent injury is understood as permanent defect of structure and function of an organ or extremity. In the understanding hereof a permanent health detriment means only and exclusively those types of detriments which are listed in the Percentage table of benefits under permanent health detriment found in 16 item 3 hereof. 48. Policyholder - a natural person, legal entity or an organizational unit without legal personality which concludes the insurance contract and is obliged to pay insurance premium. 49. Insured - a natural person with permanent residence in the Republic of Poland or outside it, for the benefit of whom the insurance contract has been concluded. 50. Beneficiary - the person authorized to receive the benefit in the case of the Insured s death, appointed by name by the Insured. In the case the beneficiary has not been appointed, the members of the Insured s family are entitled to receive the benefit in the following order: spouse, children, parents, and other statutory heirs. 51. Practising record-seeking sports - a form of physical activity consisting of practising sports disciplines: a) as part of sports sections or clubs, while simultaneously participating in competitions or practice preparing for competitions, or b) as regards persons practising individual sports - by persons participating in professional, national or international competitions, organized by a sports association in charge of the given discipline or c) as regards sports games - by persons being members of clubs participating in professional, national or international competitions, organized by a sports association in charge of the given discipline, or 4) by persons authorized on the basis of an employment contract or a civil law contract to receive any form of remuneration in connection with the sport discipline being practised, including scholarship or refund of costs. 7

8 8 3. CONCLUSION OF INSURANCE CONTRACT 1. The insurance contract is concluded on the Policyholder s request. 2. In the TRAVEL variant the insurance contract may cover either an individual or a group. 3. A group contract is applicable provided that it covers all Insureds, in accordance with the list of names, by the same scope of insurance with the same sum insured. 4. A list of names for the collective contracts referred to in item 3 must be attached to the insurance document. In the case of insurance contracts concluded based on a general agreement, the list of names is made following a template delivered by SIGNAL IDUNA and kept by the Policyholder, who is obliged to successfully forward it to SIGNAL IDUNA in accordance with the general agreement. 5. An insurance contract may be concluded by the Policyholder for the benefit of a third person (the Insured). 6. Unless agreed otherwise, an insurance contract must include: The Insured s name, surname, date of birth or PESEL no. (in the case of citizens of the Republic of Poland) as well as the Insured s place of residence or full entity name, Tax Identification Number and address of the company, enterprise or institution. Additionally the Policyholder is obliged to notify SIGNAL IDUNA of all the circumstances known to it and having impact on increasing the probability of the occurrence of an insured event, which SIGNAL IDUNA asked about before concluding the insurance contract. 7. During the term of the contract both the Policyholder and the Insured are obliged to report in writing all changes in the circumstances referred to in item 6, immediately upon being notified thereof. 8. If the information provided on the circumstances referred to in item 6 is not true, SIGNAL IDUNA is not liable for the consequences of such circumstances, unless such circumstances do not result in an increased probability of the occurrence of an event covered by the insurance. If untrue information is stated intentionally, in case of doubt it is deemed that an insured event and consequences thereof result from the circumstances on which untrue information was stated. 9. The person entitled under the insurance contract is the one for the benefit of whom the insurance contract was concluded. The Insured, besides the Policyholder, is responsible for observing the duties under the insurance contract. 10. The Policyholder is obliged to notify the Insured of his/her duties arising from the insurance contract. 11. Under the BUSINESS variant the contract can be concluded either in personal or bearer version (with a limit of man-days). 12. The insurance document in the personal version must include the data set forth in item 6 while in the bearer version the following data are required: a) Policyholder s data (name, Tax Identification Number and address of the company, enterprise, institution etc.), b) Term of the contract, c) Scope of insurance and sum insured, d) Number of man-days covered by insurance during the term of the insurance contract (the minimum limit of man-days per insurance contract being 100). 13. In the case of bearer contracts (BUSINESS variant), unless agreed otherwise, the Policyholder is obliged, at the latest on the date of the Insured s departure, to effectively notify SIGNAL IDUNA (or an authorised Agent) of the

9 trip, including names and surnames, dates of birth and places of residence of the trip participants, as well as the date of departure and return. The notification is deemed effective if it is received by SIGNAL IDUNA directly or using the form of contact indicated by SIGNAL IDUNA, before the Insured starts the trip. The Policyholder keeps a register of Insureds and their dates of trips prepared according to the template agreed by SIGNAL IDUNA. 14. Unless otherwise agreed, the bearer contract (BUSINESS variant) covers persons employed and indicated by the entrepreneur with one scope of insurance, with the sums insured. 15. SIGNAL IDUNA confirms the conclusion of an insurance contract by issuing an insurance document. 4. INSURANCE PERIOD/LIABILITY PERIOD 1. Insurance contract may be concluded for the period from 1 day to 1 year which is the maximum. 2. The insurance period is indicated in the insurance document. 3. SIGNAL IDUNA insurance is effective starting not earlier than on the date (hour) on which the insurance document is issued and the premium is paid and not later than at the end of the day specified in the insurance document; moreover: a) In the case of personal accident, travel luggage and sports equipment insurance, SIGNAL IDUNA insurance becomes effective the moment the journey starts, i.e. the Insured leaves home, and ends the moment the journey is finished - the Insured returns home (the insurance is effective in the territory of the Republic of Poland for the first 24 hours of the trip only, and, after crossing the border, uninterruptedly until the journey is ended, not later though than until the end of the insurance period indicated in the insurance document), b) In the case of medical expenses and assistance, legal protection and aid as well as third party liability insurance the cover is effective from the moment of crossing the border of the Republic of Poland when leaving, and until the moment of crossing the border when returning to the Republic of Poland, c) In the case of persons starting their trip from a country other than the Republic of Poland, the insurance of all types is effective from the moment of crossing the border of the starting country and until the moment of crossing this border when returning. 4. If the person or object for whose benefit the insurance contract is concluded stays: a) outside the territory of the Republic of Poland - applies to persons for whom the Republic of Poland is a country of permanent residence or b) in the territory of the Republic of Poland or outside of the country of permanent residence - applies to persons for whom the country of permanent residence is a country other than the Republic of Poland,then the liability of SIGNAL IDUNA begins upon expiry of 5 days, counting from the day following the day the insurance contract is concluded, not earlier though than the moment the premium is paid. The above waiting period does not apply to renewals of the insurance contract, provided that the renewal is made before the expiry of the insurance period ensuing from the previously concluded insurance contract. Extension of the insurance period requires that a new insurance document be issued. During the waiting period SIGNAL IDUNA collects the premium exclusively for the period of the insurance cover provided. 9

10 5. In the case of BUSINESS insurance version the provisions of items 2, 3, 4 and the provisions below apply: a) The insurance contract is concluded for a period of 6 or 12 months in the personal variant or for 12 months in the bearer variant, with a possibility of continuation in the following 6-month or 12month insurance periods, b) In the case of personal insurance variant, SIGNAL IDUNA s cover is provided during all the trips of the Insured during the term of the contract, regardless of the number of such trips, provided that such a trip does not exceed 60 days; in the case of trips lasting longer than 60 days the insurance only covers the first 60 days, c) In the case of bearer insurance variant, SIGNAL IDUNA s cover is valid during the term of the contract, only for the number of man-days for which the premium has been paid, d) In the case of bearer contracts SIGNAL IDUNA s liability begins the moment SIGNAL IDUNA is notified of the trip, e) In the case of bearer contracts, SIGNAL IDUNA s liability ends the moment the trip is ended, but not later than on the date specified in the insurance document and not later than at the end of the day specified as the end date of the trip in the notification of the trip, f) In the case of bearer contracts, the cover period may only be extended before the end date of the trip specified in the notification of the trip and requires that a new notification be sent to SIGNAL IDUNA. Furthermore, item 4 applies accordingly. 6. Where a planned return from a trip abroad is cancelled due to volcanic eruption, strike or riot, hurricane, flood or earthquake which started during the Insured s stay abroad, SIGNAL IDUNA provides additional insurance cover of medical expenses referred to in 13 items 2, 4 and 5 starting from the end of the insurance period specified in the insurance document till the date on which such a return is possible, however not longer than for seven days WITHDRAWAL AND TERMINATION OF INSURANCE CONTRACT 1. The insurance contract concluded for a period exceeding 6 months may be terminated by Policyholder within 30 days and, in case of the Policyholder being a legal entity, within 7 days from the date of contract conclusion. The fact of withdrawing from the insurance contract does not release the Policyholder from the obligation to pay the premium for the period during which SIGNAL IDUNA provided insurance. 2. No handling charges are deducted if termination takes place within the statutory time. 3. The amount of premium due for reimbursement is calculated proportionally to the length of the unused insurance period, where every started day is deemed fully used. 4. In the case of BUSINESS variant of insurance, the provisions of items 1, 2 and 3 apply; moreover, the following must be taken into consideration: a) if the limit of man-days of insurance is not used up during the term of the insurance contract taken out in the bearer version, the unused man-days can be moved to the next insurance period if the contract is renewed for another 12 months at the Policyholder s request; the above does not release the Policyholder from the duty to pay for the minimum number of man-days (100) for the new insurance period. Where the insurance contract is not renewed, the unused man-days are not reimbursed,

11 b) the Policyholder is obliged to pay the premium for the number of man-days of cover specified in the contract on the date of concluding the insurance contract; during the term of the contract the Policyholder may, upon payment of additional premium, increase the number of man-days of cover, c) if the number of man-days of cover specified in the contract is exhausted, and the insured event occurs afterwards, SIGNAL IDUNA is released from the duty to pay the compensation unless the parties agree otherwise. 5. Withdrawal from the insurance contract should be performed in writing, otherwise being null and void. 6. If the Policyholder wants to withdraw from or terminate the insurance contract and apply for a refund of the insurance premium, he is obliged to return the original insurance contract to SIGNAL IDUNA and to sign an insurance contract withdrawal or termination form. 6. SUM INSURED 1. The sum insured is agreed with the Policyholder and the amount thereof is determined based on the tariff table in force on the date of taking out insurance, and constitutes the upper limit of SIGNAL IDUNA s liability. The sum insured indicated in the insurance document in case of a group contract means the sum for every Insured. 2. The average PLN to EUR exchange rate as defined by the National Bank of Poland and valid on the day preceding the date of concluding the insurance contract (after noon) is used for determining the sum insured. 3. The provisions of items 1 and 2 and the ones below apply for the purposes determining the sum insured for each risk specified in the present GT&C: a) in the case of medical expenses (incl. rescue) and assistance insurance: 1) the sum insured is agreed with the Policyholder for one and all events during the insurance period, 2) SIGNAL IDUNA reimburses the costs of medical expenses (incl. rescue) and assistance resulting from sudden illness or personal accident until the sum specified in the insurance document is exhausted, subject to the provisions of the present GT&C where a separate amount has been determined for individual services, 3) in the case of travelling to the USA, Canada, Japan, Australia or to Caribbean Islands, the limit to be used from the selected sum insured for out-patient treatment, purchase of medicines and dressing materials as prescribed by the doctor may not exceed PLN equivalent of EUR 2,000.00, b) in the case of personal accident insurance, the sum insured specified in the insurance document constitutes the upper limit of SIGNAL IDUNA s liability per Insured; c) in the case of travel luggage and sports equipment insurance, the sum insured determined by the Policyholder should reflect the market value of such travel luggage or sports equipment; d) in the case of third party liability insurance: 1) the sum insured specified in the insurance document constitutes the upper limit of SIGNAL IDUNA s liability related to all insured events occurring during the insurance period, regardless of the number of persons who caused the damage or contributed to the occurrence thereof, 11

12 2) the sum insured for one and all events in the area of property damage related to amateur practising of sports and practising winter sports amounts to 25% of the sum insured specified in the insurance document, 3) the sum insured for one and all events in the area of bodily injuries related to amateur practising of sports and practising winter sports amounts to 50% of the sum insured specified in the insurance document, e) in the case of legal protection and aid insurance: 1) SIGNAL IDUNA grants a loan to cover a bail in money up to the PLN equivalent of EUR 10,000.00, 2) SIGNAL IDUNA reimburses the costs of a lawyer established for the purposes of pursuing the Insured s claims arising from tort, up to the PLN equivalent of EUR 2,000.00, as well as costs of legal aid granted in order to have the Insured released from custody, up to the PLN equivalent of EUR 1, The summary of sums insured for each type of insurance is presented in the following table (SI - sum insured, CMT - costs of medical treatment, PA - personal accident, TL - travel luggage, SE - sports equipment, TPL - third party liability): STANDARD OPTION SUPER OPTION 12 SUM INSURED/SUM GUARANTEED COSTS OF MEDICAL TREATMENT From EUR 10, to 100, Rescue costs Up to EUR 6, ASSISTANCE Up to SI CMT except the USA, Canada, Out-patient clinic Japan, Australia and the Caribbean Islands - up to EUR 2, Dental treatment of sudden inflammations Up to PLN Daily hospital allowance (continuation of treatment in the Republic PLN per day, 10 days maximum of Poland) Transport to and between medical care units after the Insured's return Up to SI CMT, 10 days maximum to the Republic of Poland Transport of the Insured to the To the Republic of Poland - up to SI CMT country of permanent residence in connection with the need to be To a country other than the Republic of treated or on treatment completion Poland - up to EUR 5, Medical transport of the Insured abroad to or between medical Up to SI CMT care units Transport of the Insured on treatment completion for the purpose of Up to EUR continuing the journey To the Republic of Poland - up to SI CMT Transport of the Insured s corpse To another country - up to EUR 5, Meals and accommodation for the accompanying person staying with the Insured s corpse Up to EUR per day, 7 days maximum

13 Costs of return transport of the person accompanying the deceased Journey of the accompanying person Meals and accommodation for the accompanying person Visit of a person indicated by the Insured Costs of the Insured's convalescence Purchase of coffin or urn (cremation) Meals and accommodation for the carer Additional costs of the carer's trip Transport of the carer on completion of the Insured's treatment for the purpose of continuing the journey Extension of the insurance cover as a result of volcanic eruption, strikes, riots, hurricane, flood, earthquake Coverage of additional costs of prolonged stay abroad (only in the case of insurance contracts concluded on the basis of the general contract) Care of family members (transport of members of the Insured's family) Care of minor children (transport of the Insured's children) Transport of the Insured to the Republic of Poland in the case of trip interruption STANDARD OPTION SUPER OPTION To the Republic of Poland - up to SI CMT To another country - up to EUR 2, To the Republic of Poland - up to SI CMT To another country - up to EUR 2, Up to EUR per day, 7 days maximum Costs of transport - up to SI CMT Meals and accommodation - up to EUR per day, 7 days maximum Up to EUR per day, 7 days maximum Up to SI CMT Up to EUR per day, 7 days maximum To the Republic of Poland - up to SI CMT To another country - up to EUR 2, Up to EUR Up to SI CMT, 7 days maximum Up to EUR during the period from 3rd to 5th day of the prolonged stay - Up to SI CMT - Up to SI CMT - Up to SI CMT Driver's substitution - Up to EUR Assistance in case of a delayed flight - Up to EUR Transport of a replacement person (only in BUSINESS variant) - Up to SI CMT Costs of cancelling the participation in a golf event (only in BUSINESS - Up to EUR variant) Organization of money transfer - Up to EUR

14 Reimbursement of costs of prolonged care of household pets Reimbursement of costs of a ski pass Reimbursement of costs of ski equipment rental STANDARD OPTION - SUPER OPTION Up to PLN per day, 7 days maximum - Up to EUR EUR per day, up to EUR maximum LEGAL PROTECTION AND AID Costs of legal protection Up to EUR 2, Costs of legal aid Up to EUR 1, Security deposit Up to EUR 10, Personal accident From PLN 15, to 100, Benefit in the case of complete health detriment or death 100% of SI PA Benefit in the case of partial health detriment Specific % of SI PA TRAVEL LUGGAGE From PLN 1, to 5, Photographic and computer equipment, audio-visual equipment and Up to 50% of SI TL mobile phones Costs related to a delay in the delivery of luggage by air carrier Up to 50% of SI TL (only in BUSINESS variant) SPORTS EQUIPMENT From PLN 1, to 5, TPL From EUR 30, to 100, Bodily injuries related to amateur practising of sports or winter sports Up to 50% of SI TPL Property damage related to amateur practising of sports or Up to 25% of SI TPL winter sports INSURANCE PREMIUM 1. The insurance premium is determined depending on the following: a) insurance variant (TRAVEL or BUSINESS), b) scope of insurance specified in 1 item 2, c) option of medical expenses and assistance insurance (standard or super option), d) cover of additional risks mentioned under 1 item 3 (additional loadings), e) sum insured, f) insurance period, g) geographic area (depending on zone): 1) zone 1 - countries situated in Europe and in the Mediterranean Basin (Albania, Algeria, Andorra, Austria, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, the Canary Islands, the Channel Islands, Croatia, Cyprus, Czech Republic, Denmark, Egypt, Estonia, Faroe Islands, Finland, France, Germany, Gibraltar, Greece, Hungary,

15 Iceland, Ireland, Isle of Man, Israel, Italy, Jan Mayen Island, Jordan, Kosovo, Latvia, Lebanon, Libya, Liechtenstein, Lithuania, Luxembourg, Macedonia, Malta, Moldova, Monaco, Montenegro, Morocco, the Netherlands, Norway, Poland, Portugal, Romania, Russia, San Marino, Serbia, Slovakia, Slovenia, Spain, Svalbard, Sweden, Switzerland, Syria, Tunisia, Turkey, the UK, Ukraine, the Vatican, and all the islands of the Mediterranean, Northern and Baltic Sea 2) zone 2 - all countries worldwide, h) forms of concluding insurance contracts (personal, bearer - declared number of man-days), i) Insured s age (premium loading for persons aged above 65, premium discount for persons aged below 25; if an Insured aged over 65 pays a loading for the consequences of chronic and neoplastic diseases, the age loading does not apply), j) premium rates as defined in the tariff valid on the date of insurance contract conclusion, k) EUR exchange rate - the premium rate is calculated in PLN based on the average PLN/EUR exchange rate as announced by the NBP and valid on the last working day (after noon) preceding the day of insurance contract conclusion. 2. Unless agreed otherwise, the Policyholder/Insured is obliged to pay the premium on the day of insurance contract conclusion. 3. The premium is payable one-off in Polish currency in cash or cashless from. 4. If the premium is paid in cash, the moment the premium is paid is the moment cash is paid to an authorized representative of SIGNAL IDUNA. 5. If the premium is paid by a transfer to an appropriate bank account of SIGNAL IDUNA, then the day of payment is the day on which the transfer is made. 6. If the premium is paid by a credit card or through a website, then the day of payment is the day on which the payment is authorized. 8. PROCEDURE IN THE EVENT OF DAMAGE GENERAL PROVISIONS 1. Unless the provisions of the following paragraphs provide otherwise, the Insured is obliged to notify SIGNAL IDUNA of every insured event without delay, but not later than within 7 days of becoming aware of it, and where this is impossible, within 7 days of the date of return to homeland. 2. The Insured is obliged to release the doctors treating him/her in the country of permanent residence and abroad from keeping doctor-patient confidentiality with regard to SIGNAL IDUNA and to consent to his/her treatment documentation being made available to SIGNAL IDUNA; in the case of public and non-public health care centres, the Insured is obliged to release them from the duty to keep confidentiality and to consent to make all kinds of medical documentation available to SIGNAL IDUNA upon request. 3. Where the Insured becomes aware of preparatory proceedings being initiated or legal action being taken against him or her, he or she should notify SIGNAL IDUNA thereof without delay, even if he or she personally notified SIGNAL IDUNA of the insured event in question. 4. The Insured is obliged to use all the measures available to mitigate the damage and prevent it from extending. The Insured is also obliged to enable SIGNAL IDUNA to perform the necessary actions to determine the circumstances of the occurrence of damage, the grounds for the claim and the amount thereof. 15

16 5. The Insured is obliged to grant to SIGNAL IDUNA all the powers necessary to carry out any compensation procedures, including power of attorney ad litem, if the injured takes legal action against the Insured. The above does not release the Insured from his/her duty to raise objections or appeal on time, in reply to reminders or orders of administrative bodies. 6. The Insured is obliged to notify SIGNAL IDUNA whether he/she possesses any insurance document other than the one issued by SIGNAL IDUNA, covering the same risk. 7. If a claim is made, the Insured is not entitled to take any steps aiming at having it accepted or satisfied or at reaching a compromise with the injured unless SIGNAL IDUNA consents to it. Should the above provision be infringed, SIGNAL IDUNA is released from the duty to perform, unless the Insured could not have acted otherwise given the circumstances. 8. Special provisions on the procedure in the case of occurrence of damage under a given risk are presented in separate paragraphs DETERMINATION AND PAYMENT OF BENEFIT/COMPENSATION UNDER MEDICAL EXPENSES, PERSONAL ACCIDENT, THIRD PARTY LIABILITY, TRAVEL LUGGAGE AND SPORTS EQUIPMENT INSURANCE 1. Determination of the grounds for and amount of the benefit takes place on the basis of the documents submitted by the Insured or Beneficiary; however, SIGNAL IDUNA is entitled to verify such documents and consult them with specialists. 2. The grounds for and the amount of benefit or compensation, depending on the type of damage, are determined based on: a) documents certifying the need of immediate medical treatment as the consequence of a sudden illness or a personal accident as defined under 15 point e) and 18 point e), b) original invoices and/or payment receipts for any medical services, ambulance, as well as the invoices for the purchased medicines and dressing materials, c) original invoices and/or payment receipts for the transport of the Insured s corpse to homeland or for the burial abroad, d) original invoices and/or payment receipts evidencing other expenses related to the sudden illness, personal accident or any other events covered, e) police report drawn up at the place of accident, f) in the case of suffering wounds or other injuries, medical documentation from the date of event or the beginning of treatment (e.g. case record) including a description of wounds and injuries sustained or consequences thereof, g) in the case of death - death certificate and other documents connected with this event, including but not limited to documents with information on the reasons for the death, h) police report concerning the loss or theft of travel luggage or robbery, i) statements of the witnesses to the event, j) a license for driving a vehicle, k) a document from transport agent confirming flight or luggage delay, l) certificate from the carrier (airline, railway, bus or ferry transport agent) on its inability to provide the transport service due to volcanic eruption, strike or riot, hurricane, flood or earthquake, m) original invoices and/or payment receipts confirming prolonged stay abroad due to volcanic eruption, strike or riot,

17 n) school s declaration that the given person was a guardian during a trip organized by the school or at its request by the tour operator, taking into account the date of the trip and its destination, o) document confirming the ownership of a dog or a cat, p) original invoices and/or payment receipts confirming the costs of prolonged stay at an animal hotel, together with the animal hotel s declaration indicating the number of days of prolonged stay, q) original invoices and/or payment receipts confirming the rental of ski equipment, r) original invoices and/or payment receipts for ski passes, together with a document confirming the price of the ski pass and the number of days, s) original invoices and/or payment receipts for participating in ski or snowboarding lessons, t) other documents necessary to determine SIGNAL IDUNA s liability. 3. SIGNAL IDUNA covers any justified and evidenced medical expenses directly on account of medical care unit or via Emergency Call Centre. 4. In the case of Personal Accident Insurance, the following provisions apply: a) types and amounts of the benefits to be paid are determined upon finding the causality between the accident and the Insured s death or permanent health detriment, b) determination of the causality as mentioned under item 4 point a) hereof and the types and amounts of benefits to be paid is done on the grounds of the provided documents, as specified under item 2, c) the sum insured determined in the insurance contract is paid out in the case of 100% detriment to health or death, if the Insured dies in the consequence of a personal accident within 2 years of the date of accident; in the case of partial detriment to health, a percentage of the sum insured corresponding to the percentage of permanent detriment the Insured has suffered is granted, d) the degree of permanent health detriment is determined by doctors appointed by SIGNAL IDUNA, on the basis of the Percentage table of benefits under permanent detriment to health, found in 16 item 3 hereof, e) the degree of permanent health detriment is established promptly upon completion of treatment including rehabilitation, 24 months from the date of accident at the latest, f) in the case of loss or damage of an organ or system whose functioning had already been handicapped prior to the accident because of a disease or permanent disability, the degree of permanent health detriment is determined as the difference between the degree of permanent health detriment after the accident and the one existing prior to the accident, g) when determining the degree of permanent health detriment, such factors as the kind of work or other activities performed by the Insured are not taken into consideration, h) if the Insured receives the benefit because of the permanent health detriment and then dies in the consequence of the same accident, then the death benefit is paid whereby the amount formerly paid is deducted, i) if the Insured dies after the degree of permanent health detriment had been determined and the death remains in no causality with the accident, the permanent health detriment benefit which was not paid to the Insured prior to his/her death, is paid to beneficiary; if there is no beneficiary appointed by name, then burial costs are returned to the person who incurred such costs, j) if the degree of permanent health detriment is not determined before the Insured s death, and the Insured s death is caused by an event other than the accident being the cause of health detriment, the probable degree 17

18 of permanent health detriment determined by SIGNAL IDUNA doctors is assumed, and the benefit arising out of it is paid to the Beneficiary, k) in the case of the Insured s death after a lapse of 24 months of the date of the personal accident, the causality between the accident and the Insured s death is not recognized. 5. In respect of travel luggage/sports equipment, the amount of benefit is determined according to the cost of repair or the real value of the article taking its degree of real wear into account. The value of the article is determined by SIGNAL IDUNA on the basis of the original purchase invoice or the value of the new article of identical or similar performance traits on the date of event occurrence. 6. In the case the stolen or damaged articles forming part of the Insured s travel luggage or sports equipment are recovered, the Insured is obliged to notify SIGNAL IDUNA about this fact without delay. The compensations paid out for lost property or sports equipment are returnable. Upon consent of SIGNAL IDUNA the returned compensation can be decreased by the value of defects and faults found in the recovered articles. 7. A deductible of 5% of the damage applies to every compensation payment with reference to loss or destruction of sports equipment (sports equipment insurance). 8. If the Policyholder fails to fulfil any of the duties mentioned under 8, 15, 18, 21, 24, 29 hereof intentionally or through gross negligence, or fails to provide the documents required by the Insurer and defined under item 2 hereof, SIGNAL IDUNA is entitled to reduce the payment of compensation accordingly if such a violation results in the increase of loss or makes it impossible to determine the circumstances and consequences of an insured event. 9. If the same subject of insurance is covered under the same risk with two or more insurers at the same time for the sums which exceed its insurance value, each of the insurers is liable up to the amount of damage in such a ratio as the sum insured accepted by it remains to the total of the sums resulting out of such double or multiple insurance (with the exclusion of personal accident insurance). 10. In the event of the Insured s death, if no Beneficiary is appointed by name, the person filing a claim for compensation/benefit is obliged to submit a copy of the death certificate and a document confirming his/her consanguinity or affinity with the Insured. If the Insured was single, a document confirming the right to compensation is required. If the Beneficiary was appointed by name, the following documents are required: ID, copy of death certificate and a document confirming the fact of being entitled to the compensation/ benefit. 11. Any compensation/benefit resulting out of the insurance contract is paid in PLN for the benefit of the Insured, Beneficiary or Injured. In the case of Insureds, Beneficiaries or Injured having their permanent place of residence outside the Republic of Poland, the payment can be made by a bank transfer in EUR or USD. 12. The expenses incurred in foreign currencies are converted into PLN according to the average exchange rate announced by the Chairman of NBP and valid on the day preceding the date of determining the benefit (after noon). 18

19 10. DEADLINE FOR PAYMENT OF BENEFIT 1. SIGNAL IDUNA pays the benefit within 30 days of the date the claim is reported. 2. If the circumstances, necessary for the liability of SIGNAL IDUNA or determination of the amount of benefit, are impossible to be explained within the above period of time, the benefit is paid within 14 days of the date on which the explanation of such circumstances, with proper care, is possible; however, SIGNAL IDUNA is obliged to pay the indisputable part of the benefit, understood as the evidenced part of the benefit being beyond doubt, within the period specified under item If the benefit is not payable or the amount payable is other than requested in the claim form, SIGNAL IDUNA informs the Insured/Beneficiary about it in writing within the deadline specified in item 1 above, indicating the circumstances and the legal basis justifying the refusal to pay the benefit. 4. SIGNAL IDUNA informs the Insured in writing about the amount of the benefit granted. 11. PROCEDURE FOR EXAMINING APPEALS, COMPLAINTS AND REQUESTS 1. The Insured/Policyholder/Beneficiary is entitled to appeal SIGNAL IDUNA s substantive decision concerning the scope of the granted benefit or its refusal to grant one to the Management Board of SIGNAL IDUNA within 30 days of the date of issuing such a decision. 2. SIGNAL IDUNA settles the appeals within 30 days of the receipt thereof. 3. Furthermore, in the case of matters other than the ones referred to in item 1, the Policyholder or the Insured may file a complaint with SIGNAL IDUNA. 4. Complaints are settled within 30 days of the receipt thereof and the person who filed such a complaint is notified promptly of the result of the procedure. 5. The content of a letter is decisive for such a letter to be qualified as an appeal or complaint. 6. Any claims resulting out of the insurance contract can be sued for either on the basis general regulations or before the court of justice competent for the residence or place of registered office of the Policyholder or the Insured. 12. RECOURSE CLAIMS 1. On the date of benefit payment SIGNAL IDUNA takes over, by virtue of the law, any claims (recourse) against a third party responsible for the damage up to the amount of the benefit paid. 2. If SIGNAL IDUNA has covered a part of the damage, the Insured is entitled to satisfy his/her claims prior to the claims of SIGNAL IDUNA in respect of the remaining part of such damage. 3. SIGNAL IDUNA does not take over any claims against the persons with whom the Insured remains in the common household, unless the damage was inflicted intentionally. 4. If the Insured, without consent of SIGNAL IDUNA, waives a claim against a third party responsible for the damage, or limits such a claim, SIGNAL IDUNA may refuse the payment of the benefit or reduce it. 19

20 5. If the claim waiver or limitation is disclosed after the benefit has been paid, SIGNAL IDUNA may demand the Insured to return the whole amount of the benefit paid or a part thereof. STANDARD OPTION II. MEDICAL EXPENSES AND ASSISTANCE INSURANCE 13. SUBJECT OF INSURANCE 1. The subject of insurance under standard option are medical expenses and costs of assistance incurred by the Insured who, while staying outside of his/ her country of permanent residence, had to undergo an immediate treatment in the consequence of a sudden illness or a personal accident. 2. Medical expenses are considered to be any expenses which occurred outside the country of the Insured s place of permanent residence, and were incurred for the following: a) medical examinations and procedures prescribed by a medical doctor in the consequence of a sudden illness or a personal accident, b) appointment with a doctor, including the doctor s transport to the Insured s current location, c) purchase of necessary medicines and dressing materials prescribed by a medical doctor, d) a stay at an out-patient clinic or hospital (medical procedures, doctors fees, medicines, tests, surgeries), e) delivery which occurred not later than in the 32nd week of pregnancy whereby the benefit is paid for mother and child up to the sum insured in total, f) repair and purchase of glasses and repair of artificial limbs or dentures immediately after the accident if these have been damaged in the consequence of the personal accident as defined under 2 item 30 hereof, causing a permanent health detriment of the Insured, g) dental treatment of sudden inflammations (up to PLN for all the events occurring during the term of the insurance contract); only provisional filling of the tooth is covered by insurance; any later fixed filling, channel filling, crown reconstruction is excluded; any treatment related to teeth deformation or growth incorrections as well as preventive dentistry is excluded, h) decompression chamber in medically justified cases, provided that loading for practising high risk sports, extreme sports or record-seeking sports is taken out, i) Insured s transport to an out-patient clinic or hospital justified by the Insured s state of health and approved by the Emergency Call Centre, j) Insured s transport between medical care units as recommended by the doctor leading the Insured s treatment abroad, k) transport to the place of accommodation after medical aid has been rendered, l) rescue costs, SIGNAL IDUNA covers necessary and evidenced costs incurred for rescue or search action led by special services in order to rescue life or health of the Insured who had an accident outside the Republic of Poland or the country of his/her permanent residence (which not necessarily should 20